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Individual
JAMES WOMACK
Active
Individual
JAMES WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1172
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000000240A
—
GA
01
—
7011046
AETNA
GA
01
—
970001400
RR MCARE - BCPHC
GA
Enumeration date
09/05/2006
Last updated
11/29/2011
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